A nurse cares for a client after cardiac catheterization. During assessment of the groin site, the nurse notices that the dressing is saturated with blood and a small trickle leaks down the client's leg. What should the nurse do first?

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11ecbb05_c952_f40a_b433_a39c8673777b_MD0009_00 Cardiac catheterization helps assess and diagnose coronary artery disease (eg, coronary artery patency, atherosclerosis). A catheter is advanced to the heart through a vein (eg, femoral, antecubital) for right-sided heart catheterization or an artery (eg, brachial, femoral) for left-sided heart catheterization. After the procedure, a pressure dressing is applied and the client placed supine with the affected extremity flat for 2-6 hours to promote complete hemostasis. The nurse monitors vital signs, extremity integrity (eg, pulses, sensation, capillary refill), and dressings for indications of bleeding according to institution policy. If bleeding occurs, the nurse applies direct manual pressure to the vessel puncture site (ie, about 2.5 cm [1"] above the skin puncture site) to achieve hemostasis and keep the client hemodynamically stable (Option A). The health care provider (HCP) should be notified, as the client may require further surgical intervention. (Option B) When a client is actively bleeding post cardiac catheterization, the HCP should be notified; however, the nurse should first control the bleeding. (Option C) The distal pulse is assessed routinely after cardiac catheterization to determine adequate blood flow to the extremities. However, the priority is to control active bleeding through manual pressure. (Option D) A new pressure dressing may be applied after the bleeding has stopped and hemostasis has been achieved per HCP prescription. Educational objective: If bleeding occurs after cardiac catheterization, the nurse first applies direct manual pressure to control the bleeding.

A Nurse Cares for a Client After Cardiac Catheterization